Higher Knee Flexion During Stance Phase of Gait

by MASS4D® Prescription Orthotics November 06, 2016

Participants were made to undergo a weightbearing, posteroanterior, fixed-flexion radiograph of the tibiofemoral joints (TFJs).

Individuals were requested to take three tests - a six-minute walk test, a timed up-and-go test and a stair-climbing test - to assess physical function.

Magnetic resonance images of the knee were acquired using a high-resolution, 3-D, fast spin-echo sequence in order to identify the Patellofemoral joint (PFJ) cartilage and bone marrow edema-like lesions (BMELs).

The modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) was used to define the severity of PFJ osteoarthritis (OA) progression when new or increased cartilage or BMELs were observed at 1 year.

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Three-dimensional gait analysis was performed at baseline.

During the first and second halves of the stance phase, peak knee flexion moment and knee flexion moment impulse were compared between progressors and nonprogressors, using analyses of covariance, with age, sex, body mass index (BMI), and presence of baseline PFJ OA as covariates.

Patellofemoral joint OA progressors demonstrated significantly higher peak knee flexion moment (P = .01) and knee flexion moment impulse (P = .04) during the second half of the stance phase at baseline compared to nonprogressors.

No significant difference was observed for knee flexion moment and flexion moment impulse during the first half of stance.

Hence it was concluded that peak knee flexion moment and flexion moment impulse need to be considered when treating individuals who have or are at a risk of PFJ OA.

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References:

1. Hsiang-Ling Teng, Toran D. Macleod, Thomas M. Link, Sharmila Majumdar, Richard B. Souza (2015) Higher Knee Flexion Moment During the Second Half of the Stance Phase of Gait Is Associated With the Progression of Osteoarthritis of the Patellofemoral Joint on Magnetic Resonance Imaging. Journal of Orthopaedic & Sports Physical Therapy: September 2015, Vol. 45, No. 9, pp. 656-664

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